|Número de publicación||US5282845 A|
|Tipo de publicación||Concesión|
|Número de solicitud||US 07/591,389|
|Fecha de publicación||1 Feb 1994|
|Fecha de presentación||1 Oct 1990|
|Fecha de prioridad||1 Oct 1990|
|También publicado como||CA2050620A1, EP0479435A2, EP0479435A3|
|Número de publicación||07591389, 591389, US 5282845 A, US 5282845A, US-A-5282845, US5282845 A, US5282845A|
|Inventores||Mary E. Bush, Craig E. Mar, Eric S. Fain|
|Cesionario original||Ventritex, Inc.|
|Exportar cita||BiBTeX, EndNote, RefMan|
|Citas de patentes (28), Otras citas (2), Citada por (237), Clasificaciones (7), Eventos legales (7)|
|Enlaces externos: USPTO, Cesión de USPTO, Espacenet|
This invention relates to deployable leads having electrodes which may be held in a position for inserting of the lead into the body of a patient, followed by placing of the electrodes into a position of use in which they assume a different configuration. More specifically, the invention relates to the field of implantable automatic defibrillators.
Examples of deployable defibrillation electrodes are disclosed in Fogarty et al. U.S. Pat. No. 4,860,769 and Moore U.S. Pat. No. 4,567,900 and Fain et al. co-pending U.S. Pat. application Ser. No. 404,517, filed Sep. 6, 1989.
As described in Fogarty et al. it is well known in the field of cardiology that certain types of cardiac arrhythmias known as ventricular tachycardia and fibrillation can often be effectively treated by the application of electrical shocks to the heart. Such defibrillation may be achieved by the application of electrical paddles to the chest of a patient, or directly to the heart tissue, if the chest is open during surgery.
More recent improvements have lead to the development of implantable defibrillators which monitor the heart for arrythmias and automatically initiate defibrillation when an arrythmia occurs. Such devices typically incorporate electrodes which are located next to the heart, or on an intravascular catheter, or both. Because the electrodes are closer to the heart tissue, implanted defibrillators require less electrical energy to stimulate the heart than do external electrodes.
However, major surgery is generally necessary to implant the present defibrillator lead systems, for example a median sternotomy or a lateral thoracotomy. These procedures can be very traumatic to the patient, and may have significant adverse side effects. Candidates for such procedures or any procedure include only those persons for whom the potential benefits outweigh the risks. Because of the significant surgical risks of the present lead systems, many patients who might otherwise benefit from the use of an implantable defibrillator are excluded.
While leads are generally known which are collapsed into an advancement position for implantation in the body and then are deployable to an operating position inside the body, the defibrillator lead electrodes require a substantially large area, to provide even current distribution and low defibrillation energy thresholds. Thus, difficulties are encountered in the designing of deployable defibrillator electrodes.
In electrodes such as those shown in Fogarty et al., it would be of advantage if the long, spiral electrode could be reduced in length. By this improvement, the length along which the electrode has to deploy is shorter and more controllable, and electrical resistance can be minimized. Similarly in the Moore patent, the size of the electrode, when distorted into shape for movement through a catheter as shown therein may be unduly large.
In accordance with this invention, a lead carrying multiple electrodes is provided to achieve a desired length reduction of the electrodes, as well as other significant advantages over electrodes of the prior art. For example, a multiple electrode system provides more redundance to the system so that it can continue to operate in the event of failure of one of the electrodes. Also, the lead of this invention may be inserted through a small incision with minimum trauma to the patient, while providing adequate electrode surface area for defibrillation, due to the deployable nature of the lead.
By this invention, an implantable defibrillator lead is provided. The lead comprises a flexible, conductive lead member having proximal and distal ends. The conductor of the lead member may be a coil or a multistrand cable. Means are also provided for holding the lead in a generally linear and typically straight configuration. For example, a sheath may enclose the lead in longitudinally slidable relation, whereby a distal end portion of the lead is enclosed in the sheath in a first sliding position, and the distal end portion projects from the distal end of the sheath in a second sliding position. The distal end portion defines a plurality of separate, curvilinear electrodes which collapse and straighten to fit into said sheath in the first position, and which deploy by flexing laterally outwardly in a curved arrangement from the remainder of said lead in the second position.
If desired, the sheath may be replaced by one or more stylets which communicate with each of the curvilinear electrodes to hold them straight or in any desired predetermined position until the stylets are removed. In that case also, as well as in the situation where a sheath is used, the curvilinear electrodes can be released to move laterally outwardly from the axis of the lead into operating configuration upon removal of the stylet or stylets.
The curvilinear electrodes each preferably comprise a coiled metal wire, typically close-wound, extending in a curvilinear direction, for example a spiral direction, outwardly. The coiled wire conductors are preferably free of a central member extending through the coiled wire, having its own, inherent resilience so that each electrode will naturally resume its original, curvilinear shape after being straightened in the sheath without needing a central member to provide resilience. By this means, coiled, curvilinear electrode members used in this invention can provide more positive outward springing than the electrodes of the Fogarty et al. patent, where a coiled electrode is carried on a nonmetallic, flexible, member. Also, the structure of the electrodes preferably used in this invention is more fatigue resistant than electrodes that rely on a central supporting wire for resilience.
The word "curvilinear" is intended to imply that the electrodes used in this invention extend in a curved path, referring to their general direction of extension. Each curvilinear electrode may comprise a braided cable formed of wires, or a wound coil of wire or wires or metal flat ribbon, or coaxially wound coils, with the braided or coiled array generally extending in the curvilinear direction, to define the curvilinear electrode.
Because a plurality of such curvilinear electrodes are used, they can each be substantially shorter than can the single electrode of the Fogarty et al. patent cited above, and they can be considerably less complex than the single electrode of Moore cited above.
The electrodes may comprise multifilar coils of several intercoiling strands to lower resistance, provide additional redundancy, and help the coil electrode keep its shape by increasing pitch without reducing coil density.
In one preferred embodiment, the separate, curvilinear electrodes may each define an arc having an angle of at least about 180° but less than a complete loop, i.e. not a closed, attached loop although the arc may be 360° or more. At least a pair of said separate, curvilinear electrodes defining arcs may project outwardly in opposed, transverse directions, which facilitates their free, lateral deployment at their desired site in the patient, typically near the heart, while minimizing the chances of the respective curvilinear electrodes tangling.
Alternatively, the separate, curvilinear electrodes can define a closed loop, in which both ends of the linear electrodes are attached to the lead.
Preferably, the curvilinear electrodes may comprise a platinum-iridium alloy which provides excellent physical characteristics as well as excellent electrical transmission characteristics to the electrodes. Alternatively, other alloys with good physical and electrical characteristics, such as MP35N, may be used, containing essentially 35 percent nickel, 35 percent cobalt, 20 percent chromium, and 10 percent molybdenum, by weight.
The sheath is preferably used to hold the electrodes in relatively linear relation during advancement, and then the sheath is withdrawn to permit deployment. The sheath preferably comprises an electrically insulating material such as plastic, silicone rubber, or the like. Thus the sheath may remain in position about the majority of the lead, if desired, while allowing the electrodes to be exposed distally of the sheath and to be laterally deployed.
It may also be desirable for each curvilinear electrode to have a retention member running along its length, either internally or externally, to keep the electrode intact in case of breakage. Thus, in the event of breakage or other reason, the entire system can be optionally placed back into its installing position by advancement of the sheath or stylets, and then withdrawn from the patient for replacement with a new unit. Also or alternatively, each electrode may carry a coating of platinum, iridium oxide, or the like as a protection against corrosion, where that is deemed desirable.
It may also be desirable for the curvilinear electrodes to be staggered in the same plane to provide optimum distribution of current, and also to minimize possible tangling as the electrodes are deployed. Alternatively, the respective curvilinear electrodes may be distributed in different planes so that the deployed lead is a three dimensional structure, rather than just a substantially two dimensional structure. This provides the advantages of better fixation and stability, more uniform current distribution when used endocardially, and the avoidance of tangling.
The lead of this invention may further comprise a fixation device adjacent its distal tip. Such a fixation device may comprise a known screw-in distal tip fixation device. Alternatively, a passive fixation device may be used such as outwardly extending vanes, intended to be caught on the trabeculae within the heart to hold the lead in place.
As a further alternative, the lead of this invention may carry a pacing/sensing unit adjacent its distal end, so that the lead is useful not only for defibrillation, but also for heart pacing and sensing of heart beats.
Not only may the lead carry electrodes that are straightened by an outer sleeve that is longitudinally movable, but also a removable inner stylet may be provided to pass within tubular or spiral electrodes to straighten them. Since multiple electrodes are used, the inner stylet may be of a multiple-strand cable structure in which the strand components of the cable are separated at the distal end, each component passing into an electrode for straightening thereof. Thus the lead can be held in its insertion position using an inner stylet, and then the lead electrodes assume their natural shape upon removal of the inner stylet.
As another alternative, a removable stiffening catheter may be placed along the lead and the sheath which covers the electrodes and straightens them out during advancement. This stiffening catheter can also be used to stiffen the lead during insertion as well as straighten the electrodes, if desired.
As another advantage of this invention, each electrode typically connects to the lead conductor near the center of the area of the electrodes, taken together. Thus, the current flows radially outwardly from the center along the somewhat resistive electrodes. Therefore, current is preferentially delivered to the portion of the heart adjacent the electrode center. This avoids undesirable edge effects.
A pair of leads, at least one of which is typically made in accordance with this invention, may be implanted in or adjacent the heart in such a manner that an unbroken wall of heart tissue separates the two electrodes. Thus, even in the event of some movement of one or both of the electrodes, the respective electrodes remain separated by the wall of heart tissue.
For example, one lead may be placed in the right ventricle of the heart, and another is placed intrapericardially, i.e., outside of the heart itself but within the pericardial cavity.
Alternatively, one lead may be placed in the right ventricle of the heart, and another lead is placed extrapericardially, i.e., against the outer surface of the fibrous layer of the parietal pericardium.
As a third alternative, one lead may be placed intrapericardially, while another lead is placed extrapericardially.
As a fourth alternative, both leads may be placed extrapericardially.
As a fifth alternative, both leads may be placed intrapericardially.
The leads may extend into their positions through separate holes formed in the pericardial membrane, which provides further assistance in assuring that the leads stay separated from each other.
By these means, a pair of defibrillation leads may be safely and reliably positioned in active relation with the heart, for providing defibrillation energies when and as required.
By this invention one or more deployable electrodes may be applied to the heart for defibrillation, and, if desired, for other purposes as well, without significant surgery, by simple advancement of the electrode through a small aperture to a desired site at the heart. Then, the electrode may be deployed in the manner discussed above, with the electrode being optionally secured by some mechanical means in its desired position.
In the drawings, FIG. 1 is a plan view, taken partly in section, of a multiple electrode defibrillation lead in accordance with this invention, shown in its expanded, operating configuration;
FIG. 1a shows the defibrillation lead of FIG. 1 in its position for installation into the body, with the electrodes being in their first position, fitting into a sheath;
FIG. 2a is an enlarged, fragmentary, partially broken away perspective view showing a portion of one of the electrodes of the lead of FIG. 1;
FIG. 2b is a partial, enlarged sectional view of another embodiment of the electrode of the lead of FIG. 1.
FIG. 3 is a fragmentary plan view, taken partly in section, showing another embodiment of the multiple electrode defibrillator lead of this invention;
FIG. 4 is a similar plan view, taken partly in section, of the lead of FIG. 3 in its retracted, traveling position within the sheath;
FIG. 5 is a similar view of another embodiment of the multiple electrode defibrillator lead of this invention;
FIGS. 6 through 8 are each plan views, taken partly in section, of additional, separate embodiments of the multiple electrode defibrillator lead of this invention;
FIG. 9 is a plan view, taken partly in section, of a multiple electrode defibrillator lead of this invention which is straightened into a travelling position by means of an internal stylet having multiple distal branches;
FIG. 10 is a plan view, taken partly in section, of a modified lead similar to that of FIG. 9 after the stylet has been withdrawn from the multiple electrodes;
FIG. 11 is a plan view, taken partly in section, showing another embodiment of the lead of this invention;
FIG. 12 is a schematic view of the human heart of a patient, illustrating the implantation of a pair of the multiple electrode leads of this invention;
FIG. 13 is a plan view, taken partly in section, showing yet another embodiment of the lead of this invention, in its retracted configuration;
FIG. 14 is a plan view, taken partly in section, of the lead of FIG. 13 shown in its advanced configuration in which some of the curvilinear electrodes are deployed outwardly; and
FIG. 15 is a view similar to that of FIG. 14 in which all of the curvilinear electrodes have deployed outwardly in their advanced position.
Referring to FIGS. 1 and 2, an implantable defibrillator lead 10 is disclosed which comprises a flexible, conductive, insulated lead member 12, the majority of which carries insulation 13 and is positionable within a sliding sheath 14. Lead 12 connects to a conventional electronic connector 16 for connecting with a system for sending energy pulses through the lead, at its proximal end. At its distal end, lead 12 defines four curvilinear electrodes 18. Each of the curvilinear electrodes 18 may comprise a coiled, conductive metal wire or ribbon 20 in which the axis 22 of the coil extends in said curvilinear direction. The coiled wire 20 preferably comprises a close-wound coil in which the individual loops thereof are in contact with each other, as shown in FIGS. 2a and 2b. The wire may comprise a platinum-iridium alloy for providing desired excellent physical characteristics to the electrode.
Additionally, electrode 18 may carry a length of polymeric material 24, such as silicone rubber, (FIG. 2a) extending along the length of each electrode 18 and adhering to the coils of wire 20 to keep the electrode intact, in case of breakage.
Also, wire 20 may carry outer coating 25 of iridium oxide or other corrosion resisting material, or the coils of wire 20 forming the coiled electrode may be coated with iridium oxide or the like, to reduce corrosion.
FIG. 2b shows a variant of electrode 18, in which the coils of wire 20, either coated with a protective agent or uncoated as may be desired, define an inner helical member, while an outer, coiled helical member 27 is also present. While coils of wire 20 may be of the same design as shown in FIG. 2a, the outer helical coil 27 may be made of platinum wire, typically of smaller diameter than the diameter of coils of wire 20, with the platinum coiled wire 27 serving as a protective aid against corrosion and the like.
The inner coil 20 can then provide improved shape memory and mechanical strength, coupled with the corrosion resistance provided by the outer coil 27.
Also, either of the electrode designs of FIGS. 2a or 2b may be multifilar in nature, i.e., several strands of coiled wire 20 are coiled together, so that adjacent loops of coil are from different strands. Typically from 2 to 4 separate strands may be provided in this circumstance. Such multifilar coils exhibit lower electrical resistance, provide additional redundancy, and help the electrode keep its shape by increasing the pitch of the individual, coiled strands without changing the coil density. "Pitch" is the distance from center to center of the wire in two turns of a wire in a coil. In short, coil density can be maximized as shown since the individual loops 20 are in contact with each other, but the pitch of the individual wires can be increased relative to axis 22.
The electrode is originally in its configuration of FIG. 1a, in which sheath 14 is advanced to enclose the respective electrodes 18 which, in turn, are forced into a configuration that is generally parallel to the axis of sheath 14. In this configuration, it is easier to advance lead 10 into the patient through a major blood vessel into a chamber of the heart. Lead 10 may also penetrate through a hole cut or punched in the parietal pericardium in a desired position, to enter the pericardial cavity.
Then, as shown in FIG. 1, and also as broadly shown in FIG. 12, sheath 14 may be retracted relative to electrodes 18, permitting them to assume a natural configuration by their natural resilience, moving laterally outwardly in a curved arrangement from the remainder of said lead.
The curvilinear shape of electrodes 18 may be of the form of a circle or a spiral, although in the FIG. 1 embodiment a complete, closed circle or spiral is not defined by any of the electrodes 18. The junction point 26 of each of electrodes 18 with the remainder of lead 12 may be at a position which is the radially inward most position of the electrode spiral as defined, with the remainder of each electrode 18 spiralling radially outwardly. In this manner, the current flow starts at an inner point of the spiral path of each of the somewhat resistive curvilinear electrodes 18 and moves laterally outwardly, to avoid undesirable edge effects as described above.
Thus, it can be seen that the lead of FIGS. 1-3 provides significant advantages over the leads of the prior art. A substantial amount of electrode area is provided among the four electrodes 18 over a relatively short length of the lead. Also, since each electrode 18 is relatively short in length, they do not extend outwardly from the axis of the lead by an undue distance, and thus are more easily spontaneously deployable within or adjacent the heart. Likewise, their deployable characteristic is of great advantage for the reasons discussed above, while a substantial surface area for the electrodes is provided.
Also, in the event of a failure of one of the electrodes 18, it may not be necessary to remove the lead, since the three other electrodes 18 will still be operable. Likewise, the overall resistance of the system is reduced, since each of the electrodes 18 connect directly with lead 12, and are shorter in length than would be expected from the viewpoint of the prior art for a single defibrillation electrode of equivalent capacity.
FIGS. 3 and 4 disclose an alternative embodiment in accordance with this invention. In this embodiment, a portion of lead 10a is shown, in which conductive lead member 12a is similar to lead member 12 and is terminated at its distal end with a pair of loop electrodes 26, 28. If desired, one of the loop electrodes 28 may be positioned within the other of the loop electrodes 26. Both ends of each of the electrodes 26, 28 communicate with lead member 12a.
Sheath 14a may be of similar structure and function to sheath 14 of the previous embodiment. In FIG. 4, the defibrillator lead is shown in its position to be advanced into the body to its final site of implantation. Then, when the site is released, sheath 14a is pulled backwards to deploy electrodes 26, 28 by their natural springing memory as may be desired.
As one particular embodiment, electrode 26 may, by its natural springing nature, move upwardly out of the plane of the drawing, while inner electrode 28 moves downwardly out of the plane of the drawing, so that the two electrodes occupy a three dimensional configuration.
Otherwise, the embodiment of FIGS. 3 and 4 is substantially similar in its structure and operation to the previous embodiment.
Referring to FIG. 5, defibrillator lead 10b is disclosed. As before, a conductive lead member 12b, with its distal end as shown, is enclosable within sheath 14b. As before, four electrodes 18b are shown, similar in nature to electrodes 18 of the embodiment of FIGS. 1-2. However, in this embodiment, electrodes 18b are staggered along the longitudinal dimension in a manner that is different from the electrodes 18 of FIG. 1, which are in pairs, although opposed to each other. This staggered arrangement of electrodes 18b provides an advantage that there is less opportunity for tangling of the electrodes as sheath 14b is pulled in the proximal direction to allow curvilinear electrodes 18b to flex laterally outwardly into their normal, curved arrangement as shown in FIG. 5. This particular embodiment can be used when it is acceptable to have an electrode arrangement that is of greater longitudinal extent than in the embodiment of FIG. 1. Otherwise, the embodiment of FIG. 5 is similar in structure and function to the embodiment of FIGS. 1-2.
Turning to FIG. 6, another defibrillator lead 10c is shown at its distal end, in its natural, expanded configuration.
Lead 10c comprises a conductive lead member 12cand a flexible sheath 14c in a manner similar to the previous embodiments. However, in this embodiment, the respective curvilinear electrodes 18c are staggered in a three dimensional array, which helps with fixation, and which can also serve to reduce tangling of the respective electrodes as they expand outwardly. In other words, one of the electrodes 18c, in reality, would extend upwardly out of the plane of the drawing of FIG. 6. One of the electrodes 18c would extend downwardly out of the plane. Other of the electrodes 18c could remain substantially adjacent to the plane, extending right and left therealong, to define a three dimensional array of curvilinear electrodes.
Because of the three dimensional arrangement, of the electrodes in FIG. 6, they are more likely to contact cardiac tissues when used endocardially. When used intrapericardially or extrapericardially, the three dimensional configuration will create friction forces on the heart to wedge the lead in place, thereby stabilizing it. Contrariwise, the electrodes 18, 18b of FIGS. 1 and 5 are in opposed relation to each other, but they are shown to all substantially occupy a single plane.
Referring to the embodiment of FIG. 7, a more complex lead 10d is disclosed. The electrode assembly at its distal tip comprises a sensing electrode component 30 for sensing heart action. curvilinear defibrillator electrodes 18d are provided in a manner similar to previous embodiments. Likewise, a central lumen 32 is provided to receive a stylet for straightening and stiffening if desired.
Outer sheath 14d is also provided for straightening defibrillation electrodes 18d, and then for allowing them to be deployed upon retraction of sheath 14d, as shown in FIG. 7.
Additionally, at the distal tip, a screw-in pacing electrode/fixation device 34 is disclosed, this device being known per se in the prior art.
Various conductor coals are provided in coaxial relation with each other to provide electrical communication with the respective electrodes. Conductor coil 36 communicates with defibrillator electrodes 18d. Conductor coil 38 communicates with sensing electrode 30. Conductor coil 40 communicates with pacing electrode 34, which pacing electrode also serves as a fixation device, since it can screw into the heart tissue for retention therein.
Thus, the lead of FIG. 7 is capable of sensing heart action, pacing the heart, and defibrillating.
Referring to FIG. 8, another embodiment 10e of the deployable lead of this invention is disclosed. In this embodiment, lead body 12e may comprise a cable of wound or otherwise bonded-together, separate conductors, which diverge outwardly at their distal ends to form the respective defibrillator electrodes 18e. Sheath 14e may initially overlie defibrillator electrodes 18e in the manner previously described. Then, when the electrodes are advanced to their proper position, sheath 14e may be retracted to allow the lateral curvilinear expansion of electrodes 18e as shown.
Lead extension 44 is disclosed, being bonded to the diverging strands of lead cable 12e. At the distal end of lead extension 44, lead retainer means 46 may be provided, being a plurality of radially extending vanes 48, intended for entanglement with the trabeculae of the heart interior, since the distal edges of vanes 48 are tapered, and the proximal edges 50 are not, lead 10e can typically be readily advanced into the ventricle of the heart, so that the lead becomes affixed in position and then can be withdrawn only with difficulty.
Referring to FIGS. 9 and 10, lead 10f comprises a lead body 12f made typically of a coil of conductive metal as in previous embodiments. However, at the distal end of lead body 12f, the lead body divides into a plurality of branching electrodes 18f made of wire coils. A compound stylet 52 is provided which extends through the lumen 54 of lead body 12f. Stylet 52 branches into a series of stylet branches 56, each of which branches extends into the coiled wire electrodes 18f, holding them in straight configuration as shown in FIG. 9.
Then, after implantation, lead body 52 can be pulled proximally, to cause the respective curvilinear electrodes to deploy by flexing laterally outwardly toward their natural, curved arrangement.
FIG. 10 shows a modification of FIG. 9 in which lead body 10g defines four curvilinear electrodes 18g which branch off from the lead body at two different areas rather than all branching off in a single area as in FIG. 9.
Compound stylet 58 is similar in design to stylet 52 of the previous embodiment, except that two of the branching stylet portions 60 are longer than other branching portions 61. Thus, in the original configuration, the stylet 58 in advanced position can hold curvilinear electrodes 18g in a configuration which is generally straight and parallel to the axis of the lead 10g. Then, when stylet 58 is withdrawn as shown in FIG. 10, the respective curvilinear electrodes 18g deploy outwardly in a curved arrangement from the remainder of the lead, as shown.
Referring to FIG. 11, defibrillator lead 10h shows a lead body 12h which terminates, as before, at its distal end in a series of branching electrodes 18h.
An inner stiffening catheter 62 may be provided, while outer sheath 14h is also provided to hold the respective electrodes in a generally longitudinal and straight configuration. This can be used in a situation where the lead body 12h is very flexible, and thus requires stiffening for advancement.
Then, upon emplacement, both sheath 10h and stiffening catheter 62 may be withdrawn, if desired, while the respective curvilinear electrodes 18h deflect outwardly into the desired, curved arrangement.
FIG. 12 shows the installation of a pair of leads in accordance with this invention on and in the heart. Lead 64 is shown to enter the right ventricle through the venous system. Electrodes 18 of lead 64 lie on the endocardium of the right ventricle, being in their second position, extending laterally outwardly from the lead in a curved arrangement. Alternatively, the electrodes 18 of lead 64 may be positioned to lie within the pericardial cavity or on the outer surface of the parietal pericardium.
A second lead 70 is shown to penetrate the parietal pericardium 68 through a second aperture 72, to cause its electrodes 18 to lie on the epicardium of the left ventricle. Alternatively, the curvilinear electrodes 18 of lead 70 may be positioned on the outer surface of the parietal pericardium 68, rather than being positioned between the parietal pericardium 68 and the epicardium.
Referring to FIGS. 13 through 15, another embodiment of the defibrillator lead of this invention is disclosed. As before, lead 10i defines an inner flexible, conductive lead member 12i terminating at its distal end into a plurality of separate, curvilinear electrodes 18i, some of which are longer than the other. Sheath 14i is also provided, being advanceable and retractable as in the previous embodiments, and for a similar purpose.
Also, the longer curvilinear electrodes 18i are retained at their distal ends by a wire loop 80, which is carried by a stylet 82 that extends through the length of defibrillator lead 10i.
In use, defibrillator lead 10i is advanced through the patient to its desired position while occupying the sliding position of FIG. 13 with respect to sheath 14i. Then, when the lead is properly positioned, sheath 14i may be retracted as illustrated in FIG. 14. This causes the shorter curvilinear electrodes 18i to deploy laterally outwardly as shown. However, the longer curvilinear electrodes 18i do not deploy outwardly because they are retained -in their straightened position by loop 80. Then, the user, from the proximal end of the defibrillator lead, advances or retracts stylet 82 cause loop 80 to be moved out of its engaging relation with the longer curvilinear electrodes, and optionally removed. Accordingly, the defibrillator lead electrodes all naturally deploy laterally outwardly to the desired position, as shown particularly in FIG. 15.
Thus, a multiple electrode deployable lead is provided, exhibiting substantial advantages over prior art leads, and being particularly suitable for defibrillation, but also potentially useful for other functions such as pacing and sensing of heart action.
The above has been offered for illustrative purposes only, and is not intended to limit the scope of the invention of this application,, which is as defined in the claims below.
|Patente citada||Fecha de presentación||Fecha de publicación||Solicitante||Título|
|US3749101 *||9 Feb 1972||31 Jul 1973||Cordis Corp||Nonpolarizable muscle stimulating electrode|
|US3844292 *||9 Jun 1972||29 Oct 1974||Medtronic Inc||Intravascular lead assembly|
|US3865118 *||27 Dic 1973||11 Feb 1975||Univ California||Transvenous coaxial catheter|
|US3866615 *||15 Ene 1973||18 Feb 1975||Daigle Claude W||Portable electronic cardiac stimulator|
|US3942536 *||19 Sep 1973||9 Mar 1976||Mieczyslaw Mirowski||Cardioverting device having single intravascular catheter electrode system and method for its use|
|US4112952 *||11 Feb 1977||12 Sep 1978||The United States Of America As Represented By The Secretary Of Health, Education And Welfare||Electrode for artificial pacemaker|
|US4289138 *||9 Jun 1980||15 Sep 1981||Medical Testing Systems, Inc.||Electrode assembly for temporary pacing and heart measurements|
|US4291707 *||30 Abr 1979||29 Sep 1981||Mieczyslaw Mirowski||Implantable cardiac defibrillating electrode|
|US4355642 *||14 Nov 1980||26 Oct 1982||Physio-Control Corporation||Multipolar electrode for body tissue|
|US4355646 *||26 Nov 1980||26 Oct 1982||Medtronic, Inc.||Transvenous defibrillating lead|
|US4402330 *||8 May 1981||6 Sep 1983||Medtronic, Inc.||Body implantable lead|
|US4522212 *||14 Nov 1983||11 Jun 1985||Mansfield Scientific, Inc.||Endocardial electrode|
|US4567900 *||4 Jun 1984||4 Feb 1986||Moore J Paul||Internal deployable defibrillator electrode|
|US4574814 *||8 Jul 1982||11 Mar 1986||Cardiofrance-Compagnie Francaise D'electrocardiologie||Sliding coaxial probe for a pacemaker|
|US4603705 *||4 May 1984||5 Ago 1986||Mieczyslaw Mirowski||Intravascular multiple electrode unitary catheter|
|US4662377 *||7 Nov 1985||5 May 1987||Mieczyslaw Mirowski||Cardioverting method and apparatus utilizing catheter and patch electrodes|
|US4679572 *||11 Mar 1986||14 Jul 1987||Intermedics, Inc.||Low threshold cardiac pacing electrodes|
|US4699147 *||25 Sep 1985||13 Oct 1987||Cordis Corporation||Intraventricular multielectrode cardial mapping probe and method for using same|
|US4708145 *||11 Sep 1985||24 Nov 1987||Medtronic, Inc.||Sequential-pulse, multiple pathway defibrillation method|
|US4774952 *||30 Oct 1986||4 Oct 1988||Medtronic, Inc.||Cardioversion and defibrillation lead|
|US4860769 *||12 Nov 1987||29 Ago 1989||Thomas J. Fogarty||Implantable defibrillation electrode|
|US4862887 *||27 May 1988||5 Sep 1989||Gesellschaft Fuer Strahlen Und Umweltforschung (Gsf)||Heart catheter|
|US4865037 *||13 Nov 1987||12 Sep 1989||Thomas J. Fogarty||Method for implanting automatic implantable defibrillator|
|USRE27569 *||27 Ago 1970||6 Feb 1973||Cardiac electrode catheter and heart stimulation method|
|EP0071495A2 *||29 Jun 1982||9 Feb 1983||Cardiofrance- Compagnie Francaise D'electrocardiologie||Coaxial sliding probe for a cardiac stimulator|
|EP0317490A2 *||8 Nov 1988||24 May 1989||FOGARTY, Thomas J.||Method and apparatus for implanting automatic implantable defibrillator|
|GB2217993A *||Título no disponible|
|WO1989006148A1 *||9 Ene 1989||13 Jul 1989||Knut Olof Edhag||An intravascular electrode lead usable for cardiac defibrillation|
|1||2 page article of Mansfield Scientific Inc. "Ventri-Stat Flare" Temporary Emergency Transthoracic Pacing Electrode Kit, obtained from the file history of another patent application as indicated in upper righthand corner.|
|2||*||2 page article of Mansfield Scientific Inc. Ventri Stat Flare Temporary Emergency Transthoracic Pacing Electrode Kit, obtained from the file history of another patent application as indicated in upper righthand corner.|
|Patente citante||Fecha de presentación||Fecha de publicación||Solicitante||Título|
|US5342413 *||19 May 1993||30 Ago 1994||Siemens-Elema Ab||Medical electrode arrangement|
|US5433744 *||14 Mar 1994||18 Jul 1995||Medtronic, Inc.||Medical electrical lead with super austentic stainless steel conductor|
|US5471982 *||29 Sep 1992||5 Dic 1995||Ep Technologies, Inc.||Cardiac mapping and ablation systems|
|US5526810 *||7 Oct 1993||18 Jun 1996||Wang; Dai-Yuen||Intraventricular mapping catheter|
|US5551426 *||14 Jul 1993||3 Sep 1996||Hummel; John D.||Intracardiac ablation and mapping catheter|
|US5571161 *||12 Abr 1995||5 Nov 1996||Starksen; Niel F.||Apparatus and method for implanting electrical leads in the heart|
|US5636641 *||25 Jul 1994||10 Jun 1997||Advanced Cardiovascular Systems, Inc.||High strength member for intracorporeal use|
|US5827272 *||7 Ago 1995||27 Oct 1998||Medtronic Cardiorhythm||Simplified torquing electrode catheter|
|US5855576 *||12 Dic 1996||5 Ene 1999||Board Of Regents Of University Of Nebraska||Method for volumetric tissue ablation|
|US5868740 *||24 Mar 1995||9 Feb 1999||Board Of Regents-Univ Of Nebraska||Method for volumetric tissue ablation|
|US5913887 *||27 Feb 1997||22 Jun 1999||Cardiac Pacemakers, Inc.||Device for the transvenous cardioversion of atrial fibrillation or atrial flutter including three coil electrodes|
|US5916243 *||1 Mar 1996||29 Jun 1999||Cardiac Pacemakers, Inc.||Implantable conformal coil patch electrode with multiple conductive elements for cardioversion and defibrillation|
|US5938694 *||21 Feb 1996||17 Ago 1999||Medtronic Cardiorhythm||Electrode array catheter|
|US5942276 *||16 Ene 1998||24 Ago 1999||Medtronic, Inc.||Method of manufacturing x-ray visible soluble covering|
|US5944715||25 Nov 1996||31 Ago 1999||Gyrus Medical Limited||Electrosurgical instrument|
|US5957967 *||19 Feb 1998||28 Sep 1999||Medtronic, Inc.||Implantable medical lead using stamped conductor and distal loop|
|US5995871 *||29 Oct 1997||30 Nov 1999||Uab Research Foundation||System and method for cardioversion using scan stimulation|
|US6004319||20 Jun 1996||21 Dic 1999||Gyrus Medical Limited||Electrosurgical instrument|
|US6013076||25 Oct 1996||11 Ene 2000||Gyrus Medical Limited||Electrosurgical instrument|
|US6015406||21 Ago 1996||18 Ene 2000||Gyrus Medical Limited||Electrosurgical instrument|
|US6026332 *||28 Ene 1999||15 Feb 2000||Cardiac Pacemakers, Inc.||Implantable conformal coil patch electrode with multiple conductive elements for cardioversion and defibrillation|
|US6027501||20 Jun 1998||22 Feb 2000||Gyrus Medical Limited||Electrosurgical instrument|
|US6032079 *||29 Ene 1999||29 Feb 2000||Cardiac Pacemakers, Inc.||Implantable conformal coil electrode with multiple conductive elements for cardioversion and defibrillation|
|US6038483 *||2 Feb 1999||14 Mar 2000||Cardiac Pacemakers, Inc.||Implantable conformal coil patch electrode with multiple conductive elements for cardioversion and defibrillation|
|US6041256 *||9 Jun 1999||21 Mar 2000||Cardiac Pacemakers, Inc.||Device for the transvenous cardioversion of atrial fibrillation or atrial flutter|
|US6056746||27 Mar 1998||2 May 2000||Gyrus Medical Limited||Electrosurgical instrument|
|US6083216 *||5 Ene 1999||4 Jul 2000||Intermedics Inc.||Bent cardiac lead with shape memory torque coil|
|US6085119 *||22 Jul 1998||4 Jul 2000||Cardiac Pacemakers, Inc.||Single pass endocardial lead for multi-site atrial pacing|
|US6090104 *||7 Jun 1995||18 Jul 2000||Cordis Webster, Inc.||Catheter with a spirally wound flat ribbon electrode|
|US6090106||26 Mar 1998||18 Jul 2000||Gyrus Medical Limited||Electrosurgical instrument|
|US6093186||18 Dic 1997||25 Jul 2000||Gyrus Medical Limited||Electrosurgical generator and system|
|US6094596 *||19 Jun 1998||25 Jul 2000||Angeron Corporation||Transvenous defibrillation lead system for use in middle cardiac vein|
|US6097986 *||17 Dic 1997||1 Ago 2000||Cardiac Pacemakers, Inc.||Retractable lead with mesh screen|
|US6152954||22 Jul 1998||28 Nov 2000||Cardiac Pacemakers, Inc.||Single pass lead having retractable, actively attached electrode for pacing and sensing|
|US6152955 *||29 Ene 1999||28 Nov 2000||Cardiac Pacemakers, Inc.|
|US6174308||26 May 1999||16 Ene 2001||Gyrus Medical Limited||Electrosurgical instrument|
|US6190358||20 May 1997||20 Feb 2001||Medtronic Ave, Inc.||Reinforced rapid exchange balloon catheter|
|US6210405||17 Jun 1997||3 Abr 2001||Gyrus Medical Limited||Under water treatment|
|US6212434||22 Jul 1998||3 Abr 2001||Cardiac Pacemakers, Inc.||Single pass lead system|
|US6234178||27 May 1999||22 May 2001||Gyrus Medical Limited||Electrosurgical instrument|
|US6237606||10 Mar 1999||29 May 2001||Vnus Medical Technologies, Inc.||Method of applying energy to tissue with expandable ligator catheter having multiple electrode leads|
|US6261286||16 Oct 1998||17 Jul 2001||Gyrus Medical Limited||Electrosurgical generator and system|
|US6263248||10 Sep 1999||17 Jul 2001||Vnus Medical Technologies, Inc.||Catheter having expandable electrodes and adjustable stent|
|US6269272||3 Ago 1999||31 Jul 2001||Intermedics, Inc.||Cardiac pacemaker lead with dual pitch fixation apparatus|
|US6277114||18 Mar 1999||21 Ago 2001||Gyrus Medical Limited||Electrode assembly for an electrosurical instrument|
|US6293942||2 May 1996||25 Sep 2001||Gyrus Medical Limited||Electrosurgical generator method|
|US6306134||16 Oct 1998||23 Oct 2001||Gyrus Medical Limited||Electrosurgical generator and system|
|US6308093||7 Oct 1999||23 Oct 2001||Massachusetts Institute Of Technology||Method and apparatus for guiding ablative therapy of abnormal biological electrical excitation|
|US6321122||22 Jul 1998||20 Nov 2001||Cardiac Pacemakers, Inc.||Single pass defibrillation/pacing lead with passively attached electrode for pacing and sensing|
|US6345204||14 Sep 2000||5 Feb 2002||Cardiac Pacemakers, Inc.||Single pass lead having retractable, actively attached electrode for pacing and sensing|
|US6364877||16 Oct 1998||2 Abr 2002||Gyrus Medical Limited||Electrosurgical generator and system|
|US6370412||28 Mar 2000||9 Abr 2002||Massachusetts Institute Of Technology||Method and apparatus for guiding ablative therapy of abnormal biological electrical excitation|
|US6379352||22 Mar 2000||30 Abr 2002||Ep Technologies, Inc.||Large surface cardiac ablation catherter that assumes a low profile during introduction into the heart|
|US6398780||3 Feb 2000||4 Jun 2002||Vnus Medical Technologies, Inc.||Expandable vein ligator catheter and method of use|
|US6405733||11 Jul 2000||18 Jun 2002||Thomas J. Fogarty||Device for accurately marking tissue|
|US6416509||26 Mar 1998||9 Jul 2002||Gyrus Medical Limited||Electrosurgical generator and system|
|US6438416||20 Mar 2000||20 Ago 2002||Cardiac Pacemakers, Inc.||Device for the transvenous cardioversion of atrial fibrillation or atrial flutter including three coil electrodes|
|US6454765||9 Feb 2000||24 Sep 2002||The Board Of Regents Of The University Of Nebraska||Methods for volumetric tissue ablation|
|US6463334||22 Jul 1999||8 Oct 2002||Cardiac Pacemakers, Inc.||Extendable and retractable lead|
|US6468273||9 Feb 2000||22 Oct 2002||The Board Of Regents Of The University Of Nebraska||Methods for volumetric tissue ablation|
|US6475213||27 Ene 2000||5 Nov 2002||Ep Technologies, Inc.||Method of ablating body tissue|
|US6475214||1 May 2000||5 Nov 2002||Biosense Webster, Inc.||Catheter with enhanced ablation electrode|
|US6482166||28 Mar 1997||19 Nov 2002||Advanced Cardiovascular Systems, Inc.||High strength member for intracorporeal use|
|US6482202||10 Ene 2001||19 Nov 2002||Gyrus Medical Limited||Under water treatment|
|US6501994||22 Jul 1998||31 Dic 2002||Cardiac Pacemakers, Inc.||High impedance electrode tip|
|US6505082||21 Ago 2000||7 Ene 2003||Cardiac Pacemakers, Inc.||Single pass lead system|
|US6564806||18 Feb 2000||20 May 2003||Thomas J. Fogarty||Device for accurately marking tissue|
|US6565561||3 Abr 2000||20 May 2003||Cyrus Medical Limited||Electrosurgical instrument|
|US6575967||9 Feb 2000||10 Jun 2003||The Board Of Regents Of The University Of Nebraska||Method and systems for volumetric tissue ablation|
|US6623481 *||19 Jul 2000||23 Sep 2003||Thermo-Med 2000 Kft||Electrosurgical probe for tumor treatment by radiofrequency|
|US6671561||1 May 2000||30 Dic 2003||Biosense Webster, Inc.||Catheter with electrode having hydrogel layer|
|US6682526||17 Nov 2000||27 Ene 2004||Vnus Medical Technologies, Inc.||Expandable catheter having two sets of electrodes, and method of use|
|US6684109 *||13 Sep 2000||27 Ene 2004||Oscor Inc.||Endocardial lead|
|US6689126||3 Feb 2000||10 Feb 2004||Vnus Medical Technologies, Inc.||Expandable vein ligator catheter and method of use|
|US6697676||17 Abr 2001||24 Feb 2004||Medtronic, Inc.||Medical electrical lead having an expandable electrode assembly|
|US6697677||5 Abr 2001||24 Feb 2004||Medtronic, Inc.||System and method for placing a medical electrical lead|
|US6722371||27 Oct 2000||20 Abr 2004||Thomas J. Fogarty||Device for accurately marking tissue|
|US6736843||2 Abr 1998||18 May 2004||Advanced Cardiovascular Systems, Inc.||Cylindrically-shaped balloon-expandable stent|
|US6741894||3 Dic 2001||25 May 2004||Cardiac Pacemakers, Inc.||Device for the transvenous cardioversion of atrial fibrillation or atrial flutter|
|US6745079||7 Nov 2001||1 Jun 2004||Medtronic, Inc.||Electrical tissue stimulation apparatus and method|
|US6752154||22 Ago 2001||22 Jun 2004||Thomas J. Fogarty||Device for accurately marking tissue|
|US6752767||15 Oct 2002||22 Jun 2004||Vivant Medical, Inc.||Localization element with energized tip|
|US6769433||25 May 2001||3 Ago 2004||Vnus Medical Technologies, Inc.||Expandable vein ligator catheter having multiple electrode leads, and method|
|US6780180||8 Mar 2000||24 Ago 2004||Gyrus Medical Limited||Electrosurgical instrument|
|US6827734||23 May 2002||7 Dic 2004||Advanced Cardiovascular Systems, Inc.||High strength member for intracorporeal use|
|US6961602||31 Dic 2001||1 Nov 2005||Biosense Webster, Inc.||Catheter having multiple spines each having electrical mapping and location sensing capabilities|
|US6978185||10 Jul 2002||20 Dic 2005||Oscor Inc.||Multifilar conductor for cardiac leads|
|US6999819 *||9 Nov 2001||14 Feb 2006||Medtronic, Inc.||Implantable medical electrical stimulation lead fixation method and apparatus|
|US7003342||2 Jun 2003||21 Feb 2006||Biosense Webster, Inc.||Catheter and method for mapping a pulmonary vein|
|US7041098||3 Jun 2002||9 May 2006||Vnus Medical Technologies, Inc.||Expandable vein ligator catheter and method of use|
|US7089045||30 Ago 2002||8 Ago 2006||Biosense Webster, Inc.||Catheter and method for mapping Purkinje fibers|
|US7099712||16 Feb 2005||29 Ago 2006||Biosense Webster, Inc.||Catheter having multiple spines each having electrical mapping and location sensing capabilities|
|US7160292||1 May 2003||9 Ene 2007||Vivant Medical, Inc.||Needle kit and method for microwave ablation, track coagulation, and biopsy|
|US7197363||15 Oct 2002||27 Mar 2007||Vivant Medical, Inc.||Microwave antenna having a curved configuration|
|US7228164||29 Dic 2004||5 Jun 2007||Biosense Webster Inc.||Catheter and method for mapping Purkinje fibers|
|US7245973||23 Dic 2003||17 Jul 2007||Cardiac Pacemakers, Inc.||His bundle mapping, pacing, and injection lead|
|US7257435||21 Feb 2006||14 Ago 2007||Biosense Webster, Inc.||Catheter and method for mapping a pulmonary vein|
|US7302285||30 Dic 2005||27 Nov 2007||Biosense Webster, Inc.||Catheter and method for mapping purkinje fibers|
|US7311703||18 Jul 2003||25 Dic 2007||Vivant Medical, Inc.||Devices and methods for cooling microwave antennas|
|US7318824||7 Oct 2004||15 Ene 2008||Vivant Medical, Inc.||High-strength microwave antenna assemblies|
|US7322360||10 Mar 2004||29 Ene 2008||Thomas J. Fogarty||Device for accurately marking tissue|
|US7326231 *||9 Feb 2001||5 Feb 2008||Anson Medical Limited||Device for the repair of arteries|
|US7343202||10 Jun 2005||11 Mar 2008||Ndi Medical, Llc.||Method for affecting urinary function with electrode implantation in adipose tissue|
|US7366557 *||7 Nov 2003||29 Abr 2008||Biosense Webster, Inc.||Flower catheter|
|US7366574||5 Abr 2004||29 Abr 2008||Cardiac Pacemakers, Inc.||Device for the transvenous cardioversion of atrial fibrillation or atrial flutter|
|US7406970||28 Jul 2004||5 Ago 2008||Vnus Medical Technologies, Inc.||Method of using expandable vein ligator catheter having multiple electrode leads|
|US7442183||9 Nov 2001||28 Oct 2008||Medtronic, Inc.||Techniques for selective activation of neurons in the brain, spinal cord parenchyma or peripheral nerve|
|US7468042||27 Abr 2004||23 Dic 2008||Vivant Medical, Inc.||Localization element with energized tip|
|US7546164||19 Mar 2004||9 Jun 2009||Medtronic, Inc.||Electrical tissue stimulation apparatus and method|
|US7563273 *||21 Jul 2009||Evalve, Inc.||Methods and devices for capturing and fixing leaflets in valve repair|
|US7565198||10 Jun 2005||21 Jul 2009||Medtronic Urinary Solutions, Inc.||Systems and methods for bilateral stimulation of left and right branches of the dorsal genital nerves to treat dysfunctions, such as urinary incontinence|
|US7588581||26 Mar 2002||15 Sep 2009||Medtronic, Inc.||Placement of chronic micro-catheter device and method|
|US7641633||25 Mar 2003||5 Ene 2010||Tyco Healthcare Group, Lp||Apparatus for treating venous insufficiency|
|US7647123||31 Oct 2007||12 Ene 2010||Oratec Interventions, Inc.||Method for treating intervertebral discs|
|US7736377||3 Ago 1999||15 Jun 2010||Anson Medical Limited||Devices and methods for the repair of arteries|
|US7736388||16 Ene 2007||15 Jun 2010||Evalve, Inc.||Fixation devices, systems and methods for engaging tissue|
|US7738938||13 Ago 2007||15 Jun 2010||Biosense Webster, Inc.||Catheter and method for mapping a pulmonary vein|
|US7753923||25 Ago 2004||13 Jul 2010||Evalve, Inc.||Leaflet suturing|
|US7761167||2 Oct 2006||20 Jul 2010||Medtronic Urinary Solutions, Inc.||Systems and methods for clinician control of stimulation systems|
|US7765012 *||30 Nov 2006||27 Jul 2010||Medtronic, Inc.||Implantable medical device including a conductive fixation element|
|US7774072||30 Nov 2006||10 Ago 2010||Medtronic, Inc.||Attached implantable medical elongated members|
|US7774934||8 Dic 2005||17 Ago 2010||Cardiac Pacemakers, Inc.||Method for making a terminal connector|
|US7801626||16 Dic 2005||21 Sep 2010||Raymond Moser||Instrumented retrievable implantable device|
|US7811296||27 Oct 2004||12 Oct 2010||Evalve, Inc.||Fixation devices for variation in engagement of tissue|
|US7813809||10 Jun 2005||12 Oct 2010||Medtronic, Inc.||Implantable pulse generator for providing functional and/or therapeutic stimulation of muscles and/or nerves and/or central nervous system tissue|
|US7818048 *||2 Jun 2003||19 Oct 2010||Biosense Webster, Inc.||Catheter and method for mapping a pulmonary vein|
|US7846108||10 Dic 2008||7 Dic 2010||Vivant Medical, Inc.||Localization element with energized tip|
|US7899555 *||26 Mar 2007||1 Mar 2011||Pacesetter, Inc.||Intrapericardial lead|
|US7901402||23 May 2008||8 Mar 2011||Tyco Healthcare Group, Lp||Expandable catheter having two sets of electrodes|
|US7949395 *||27 Ene 2003||24 May 2011||Boston Scientific Neuromodulation Corporation||Implantable microdevice with extended lead and remote electrode|
|US7975700||7 Feb 2006||12 Jul 2011||Koninklijke Philips Electronics N.V.||System for adjustable tissue anchors|
|US7976536||16 Nov 2005||12 Jul 2011||Tyco Healthcare Group Lp||Method and apparatus for treating venous insufficiency|
|US7981123||3 Feb 2010||19 Jul 2011||Evalve, Inc.||Surgical device for connecting soft tissue|
|US7981139||11 Abr 2006||19 Jul 2011||Evalve, Inc||Suture anchors and methods of use|
|US7992567||7 Feb 2006||9 Ago 2011||Koninklijke Philips Electronics N.V.||System and method for percutaneous glossoplasty|
|US7998151||25 Ago 2004||16 Ago 2011||Evalve, Inc.||Leaflet suturing|
|US8000805||30 Oct 2006||16 Ago 2011||Medtronic, Inc.||Implantable medical lead including tine markers|
|US8029518||30 Oct 2007||4 Oct 2011||Evalve, Inc.||Methods and devices for capturing and fixing leaflets in valve repair|
|US8032220||22 Mar 2011||4 Oct 2011||Boston Scientific Neuromodulation Corporation||Method of implanting microdevice with extended lead and remote electrode|
|US8036756||13 Feb 2006||11 Oct 2011||Medtronics Inc||Implantable medical electrical stimulation lead fixation method and apparatus|
|US8052592||7 Oct 2009||8 Nov 2011||Evalve, Inc.||Methods and devices for tissue grasping and assessment|
|US8055355 *||7 Ene 2005||8 Nov 2011||Cardiac Pacemakers, Inc.||System and assembly having conductive fixation features|
|US8057493||18 Dic 2009||15 Nov 2011||Evalve, Inc.||Fixation devices, systems and methods for engaging tissue|
|US8068921||29 Sep 2006||29 Nov 2011||Vivant Medical, Inc.||Microwave antenna assembly and method of using the same|
|US8078287||8 Jun 2007||13 Dic 2011||Cardiac Pacemakers, Inc.||His bundle mapping, pacing, and injection lead|
|US8096303||8 Ago 2007||17 Ene 2012||Koninklijke Philips Electronics N.V||Airway implants and methods and devices for insertion and retrieval|
|US8103361||16 Ago 2010||24 Ene 2012||Raymond Moser||Instrumented retrievable implantable device|
|US8123703||3 Feb 2010||28 Feb 2012||Evalve, Inc.||Steerable access sheath and methods of use|
|US8131346||17 Nov 2003||6 Mar 2012||Bard Peripheral Vascular, Inc.||Apparatus and method for implanting a preloaded localization wire|
|US8165692||3 Jul 2007||24 Abr 2012||Medtronic Urinary Solutions, Inc.||Implantable pulse generator power management|
|US8170648||25 Sep 2006||1 May 2012||Bard Peripheral Vascular, Inc.||Removable localizing wire|
|US8187299||29 Oct 2007||29 May 2012||Evalve, Inc.||Methods and apparatus for cardiac valve repair|
|US8195304||12 Oct 2007||5 Jun 2012||Medtronic Urinary Solutions, Inc.||Implantable systems and methods for acquisition and processing of electrical signals|
|US8216256||26 Feb 2009||10 Jul 2012||Evalve, Inc.||Detachment mechanism for implantable fixation devices|
|US8285376||27 Mar 2009||9 Oct 2012||Cardiac Pacemakers, Inc.||Ventricular pacing|
|US8287463 *||25 Sep 2006||16 Oct 2012||Bard Peripheral Vascular, Inc.||Removable localizing wire|
|US8290586||10 Oct 2008||16 Oct 2012||Cardiac Pacemakers, Inc.||Methods, devices and systems for single-chamber pacing using a dual-chamber pacing device|
|US8291915||27 Abr 2011||23 Oct 2012||Tyco Healthcare Group Lp||Method and apparatus for treating venous insufficiency using directionally applied energy|
|US8292880||25 Nov 2008||23 Oct 2012||Vivant Medical, Inc.||Targeted cooling of deployable microwave antenna|
|US8326423||26 Jun 2008||4 Dic 2012||Cardiac Pacemakers, Inc.||Devices and methods for steering electrical stimulation in cardiac rhythm management|
|US8343174||4 Sep 2009||1 Ene 2013||Evalve, Inc.||Locking mechanisms for fixation devices and methods of engaging tissue|
|US8346358||13 Dic 2005||1 Ene 2013||Cardiac Pacemakers, Inc.||Pacemaker which reestablishes or keeps the physiological electric conduction of the heart and a method of application|
|US8371307||8 Ago 2007||12 Feb 2013||Koninklijke Philips Electronics N.V.||Methods and devices for the treatment of airway obstruction, sleep apnea and snoring|
|US8380325||5 Ago 2009||19 Feb 2013||Boston Scientific Neuromodulation Corporation||Systems and methods for coupling coiled conductors to conductive contacts of an electrical stimulation system|
|US8406901||27 Abr 2006||26 Mar 2013||Medtronic, Inc.||Sutureless implantable medical device fixation|
|US8409090 *||26 Abr 2010||2 Abr 2013||Id, Llc||Tissue retractor and method for using the retractor|
|US8409111 *||22 Nov 2004||2 Abr 2013||Bard Peripheral Vascular, Inc.||Removable localizing wire|
|US8409273||30 Oct 2007||2 Abr 2013||Abbott Vascular Inc||Multi-catheter steerable guiding system and methods of use|
|US8423139||26 Jun 2008||16 Abr 2013||Cardiac Pacemakers, Inc.||Methods, devices and systems for cardiac rhythm management using an electrode arrangement|
|US8428715||10 Oct 2008||23 Abr 2013||Cardiac Pacemakers, Inc.||Methods for treating the physiological electric conduction of the heart|
|US8435235||25 Abr 2008||7 May 2013||Covidien Lp||Systems and methods for treating hollow anatomical structures|
|US8437848||10 Oct 2008||7 May 2013||Cardiac Pacemakers, Inc.||Apparatus for treating the physiological electric conduction of the heart|
|US8467875||28 Mar 2007||18 Jun 2013||Medtronic, Inc.||Stimulation of dorsal genital nerves to treat urologic dysfunctions|
|US8500761||11 Dic 2009||6 Ago 2013||Abbott Vascular||Fixation devices, systems and methods for engaging tissue|
|US8538521||25 Ago 2011||17 Sep 2013||Cardiac Pacemakers, Inc.||Systems, devices and methods for monitoring efficiency of pacing|
|US8543203||17 Ago 2011||24 Sep 2013||Cardiac Pacemakers, Inc.||Endocardial pacing devices and methods useful for resynchronization and defibrillation|
|US8565880||26 Abr 2011||22 Oct 2013||Cardiac Pacemakers, Inc.||His-bundle capture verification and monitoring|
|US8626314||14 Jul 2011||7 Ene 2014||Medtronic, Inc.||Implantable medical lead including a plurality of tine elements|
|US8630710||1 Mar 2007||14 Ene 2014||The Board Of Trustees Of The Leland Stanford Junior University||Implanted cardiac device for defibrillation|
|US8649870||31 Oct 2007||11 Feb 2014||Medtronic Uninary Solutions, Inc.||Systems and methods including lead and electrode structures sized and configured for implantation in adipose tissue|
|US8679110||28 Jul 2008||25 Mar 2014||Covidien Lp||Expandable vein ligator catheter having multiple electrode leads, and method|
|US8688234||18 Dic 2009||1 Abr 2014||Cardiac Pacemakers, Inc.||Devices, methods, and systems including cardiac pacing|
|US8690868||18 Dic 2006||8 Abr 2014||Covidien Lp||Needle kit and method for microwave ablation, track coagulation, and biopsy|
|US8706252||1 Jul 2010||22 Abr 2014||Medtronic, Inc.||Systems and methods for clinician control of stimulation system|
|US8734505||24 Sep 2009||27 May 2014||Evalve, Inc.||Methods and apparatus for cardiac valve repair|
|US8740918||9 Jun 2011||3 Jun 2014||Evalve, Inc.||Surgical device for connecting soft tissue|
|US8740920||22 May 2013||3 Jun 2014||Evalve, Inc.||Fixation devices, systems and methods for engaging tissue|
|US8744554||27 Mar 2012||3 Jun 2014||Bard Peripheral Vascular, Inc.||Removable localizing wire|
|US8757163||16 Ene 2012||24 Jun 2014||Koninklijke Philips N.V.||Airway implants and methods and devices for insertion and retrieval|
|US8808282||5 Mar 2007||19 Ago 2014||Covidien Lp||Microwave antenna having a curved configuration|
|US8812106||2 May 2013||19 Ago 2014||Cardiac Pacemakers, Inc.||Apparatus for treating the physiological electric conduction of the heart|
|US8825159||29 Nov 2012||2 Sep 2014||Cardiac Pacemakers, Inc.||Devices and methods for steering electrical stimulation in cardiac rhythm management|
|US8838238||4 Oct 2012||16 Sep 2014||Cardiac Pacemakers, Inc.||Ventricular pacing|
|US8886292||25 Ene 2012||11 Nov 2014||Bard Peripheral Vascular, Inc.||Apparatus for implanting a preloaded localization wire|
|US8903489||12 Oct 2012||2 Dic 2014||Cardiac Pacemakers, Inc.||Methods, devices and systems for single-chamber pacing using a dual-chamber pacing device|
|US8934969||16 Sep 2013||13 Ene 2015||Cardiac Pacemakers, Inc.||Systems, devices and methods for monitoring efficiency of pacing|
|US8977333 *||4 May 2007||10 Mar 2015||Cathrx Ltd||Shape-imparting mechanisms for catheter assemblies|
|US9008768||15 Abr 2013||14 Abr 2015||Cardiac Pacemakers, Inc.||Methods, devices and systems for cardiac rhythm management using an electrode arrangement|
|US9031648||17 Sep 2013||12 May 2015||Cardiac Pacemakers, Inc.||Endocardial pacing devices and methods useful for resynchronization and defibrillation|
|US9044246||24 Ago 2011||2 Jun 2015||Abbott Vascular Inc.||Methods and devices for capturing and fixing leaflets in valve repair|
|US9084869 *||30 Oct 2009||21 Jul 2015||Cathrx, Ltd||Catheter assembly|
|US20020062143 *||9 Nov 2001||23 May 2002||Medtronic, Inc.||Techniques for selective activation of neurons in the brain, spinal cord parenchyma or peripheral nerve|
|US20020147445 *||3 Jun 2002||10 Oct 2002||Farley Brian E.||Expandable vein ligator catheter and method of use|
|US20020148476 *||7 Jun 2002||17 Oct 2002||Farley Brian E..||Method of ligating hollow anatomical structures|
|US20040111136 *||14 Nov 2003||10 Jun 2004||Oratec Interventions, Inc., A Delaware Corporation||Method for treating intervertebral discs|
|US20040111137 *||14 Nov 2003||10 Jun 2004||Oratec Interventions, Inc., A Delaware Corporation||Method of treating intervertebral disc|
|US20040122312 *||17 Nov 2003||24 Jun 2004||Inrad, Inc.||Apparatus and method for implanting a preloaded localization wire|
|US20040133259 *||28 Ago 2003||8 Jul 2004||Cardiac Pacemakers, Inc.||High impedance electrode tip|
|US20040168692 *||10 Mar 2004||2 Sep 2004||Thomas Fogarty||Device for accurately marking tissue|
|US20040186544 *||19 Mar 2004||23 Sep 2004||Medtronic, Inc.||Electrical tissue stimulation apparatus and method|
|US20040193240 *||5 Abr 2004||30 Sep 2004||Cardiac Pacemakers, Inc.||Device for the transvenous cardioversion of atrial fibrillation or atrial flutter|
|US20040225300 *||17 Mar 2004||11 Nov 2004||Evalve, Inc.||Methods and devices for capturing and fixing leaflets in valve repair|
|US20040228650 *||13 Abr 2004||18 Nov 2004||Takashi Saito||Image forming apparatus|
|US20040242984 *||2 Jun 2003||2 Dic 2004||Plaza Claudio P.||Catheter and method for mapping a pulmonary vein|
|US20040243011 *||2 Jun 2003||2 Dic 2004||Plaza Claudio P.||Catheter and method for mapping a pulmonary vein|
|US20040254621 *||16 Dic 2003||16 Dic 2004||Jones Christopher S.||Expandable catheter having two sets of electrodes, and method of use|
|US20040267156 *||27 Abr 2004||30 Dic 2004||Vivant Medical, Inc.||Localization element with energized tip|
|US20040267258 *||28 Jul 2004||30 Dic 2004||Vnus Medical Technologies, Inc.||Expandable vein ligator catheter having multiple leads, and method|
|US20050015081 *||18 Jul 2003||20 Ene 2005||Roman Turovskiy||Devices and methods for cooling microwave antennas|
|US20050021056 *||25 Ago 2004||27 Ene 2005||Evalve, Inc.||Leaflet structuring|
|US20050101852 *||7 Nov 2003||12 May 2005||Richard Bautista||Flower catheter|
|US20050113660 *||29 Dic 2004||26 May 2005||Biosense Webster, Inc.||Catheter and method for mapping purkinje fibers|
|US20050119727 *||31 Dic 2003||2 Jun 2005||Sepehr Fariabi||High strength member for intracorporeal use|
|US20050148837 *||16 Feb 2005||7 Jul 2005||Fuimaono Kristine B.||Catheter having multiple spines each having electrical mapping and location sensing capabilities|
|US20050278000 *||10 Jun 2005||15 Dic 2005||Strother Robert B||Implantable pulse generator for providing functional and/or therapeutic stimulation of muscles and/or nerves and/or central nervous system tissue|
|US20060004421 *||10 Jun 2005||5 Ene 2006||Bennett Maria E||Systems and methods for bilateral stimulation of left and right branches of the dorsal genital nerves to treat dysfunctions, such as urinary incontinence|
|US20060004429 *||10 Jun 2005||5 Ene 2006||Ndi Medical, Inc.||Lead and electrode structures sized and configured for implantation in adipose tissue and associated methods of implantation|
|US20100030112 *||4 May 2007||4 Feb 2010||Cathrx Ltd||Shape imparting mechanism insertion|
|US20100042108 *||18 Feb 2010||Olympus Corporation||Method of cardiac surgery, and defibrillation electrode, defibrillator, and endoscope apparatus for the same|
|US20110034970 *||10 Feb 2011||Boston Scientific Neuromodulation Corporation||Neurostimulation lead and system and methods of making and using|
|US20110071360 *||24 Mar 2011||Smith Kevin W||Tissue Retractor and Method for Using the Retractor|
|US20110196298 *||30 Oct 2009||11 Ago 2011||Cathrx Ltd||Catheter Assembly|
|US20130018444 *||17 Ene 2013||Glenn Richard A||Intravascular electrodes for transvascular stimulation|
|WO1996025970A1 *||24 Feb 1995||29 Ago 1996||Bard Connaught||Reinforced monorail balloon catheter|
|WO1996039966A1 *||7 Jun 1996||19 Dic 1996||Cordis Webster Inc||Catheter with a spirally wound flat ribbon electrode|
|WO2002022202A2||12 Sep 2001||21 Mar 2002||Oscor Inc||Endocardial lead|
|WO2007103262A2 *||1 Mar 2007||13 Sep 2007||Univ Leland Stanford Junior||Implanted cardiac device for defibrillation|
|Clasificación de EE.UU.||607/128, 607/127|
|Clasificación cooperativa||A61N1/0587, A61N1/056|
|Clasificación europea||A61N1/05P, A61N1/05N|
|29 Oct 1990||AS||Assignment|
Owner name: VENTRITEX, INC., A CORP. OF CA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST.;ASSIGNORS:BUSH, MARY E.;MAR, CRAIG E.;FAIN, ERIC S.;REEL/FRAME:005489/0812
Effective date: 19900928
|10 Oct 1995||CC||Certificate of correction|
|21 Jul 1997||FPAY||Fee payment|
Year of fee payment: 4
|14 Nov 1997||AS||Assignment|
Owner name: PACESETTER, INC., CALIFORNIA
Free format text: MERGER;ASSIGNOR:VENTRITEX, INC.;REEL/FRAME:008842/0454
Effective date: 19970515
|28 Ago 2001||REMI||Maintenance fee reminder mailed|
|1 Feb 2002||LAPS||Lapse for failure to pay maintenance fees|
|9 May 2006||FP||Expired due to failure to pay maintenance fee|
Effective date: 20020201